Impact of hypertension on arterial stiffness and cardiac autonomic modulation in patients with peripheral artery disease: a cross-sectional study

Abstract

Objective: To examine the impact of hypertension on cardiovascular health in patients with symptomatic peripheral artery disease and to identify factors associated with uncontrolled hypertension. Methods: A cross-sectional study including 251 patients with symptomatic peripheral artery disease (63.9% males, mean age 67±10 years). Following hypertension diagnosis, blood pressure was measured to determine control of hypertension. Arterial stiffness (carotid-femoral pulse wave velocity) and cardiac autonomic modulation (sympathovagal balance) were assessed. Results: Hypertension was associated with higher carotid-femoral pulse wave velocity, regardless of sex, age, ankle-brachial index, body mass index, walking capacity, heart rate, or comorbidities (ß=2.59±0.76m/s, b=0.318, p=0.003). Patients with systolic blood pressure ≥120mmHg had higher carotid-femoral pulse wave velocity values than normotensive individuals, and hypertensive patients with systolic blood pressure of ≤119mmHg (normotensive: 7.6±2.4m/s=≤119mmHg: 8.1±2.2m/s 120-129mmHg: 9.8±2.6m/s=≥130mmHg: 9.9±2.9m/s, p<0.005). Sympathovagal balance was not associated with hypertension (p>0.05). Conclusion: Hypertensive patients with symptomatic peripheral artery disease have increased arterial stiffness. Arterial stiffness is even greater in patients with uncontrolled high blood pressure.

Arterial Stiffness Assessment by Pulse Wave Velocity in Patients with Metabolic Syndrome and Its Components: Is It a Useful Tool in Clinical Practice?

“…Compared to patients with normal PWV values, moderate, moderate–high, and high PWV values were responsible for a 3.03-, 5.44-, and 7.87-times higher incidence of hypertension, respectively [ 39 ]. Hypertension was associated with a higher carotid–femoral PWV, regardless of sex, age, ankle–brachial index (ABI), body mass index (BMI), walking capacity, and HR (ß = 2.59 ± 0.76 m/s, b = 0.318, p = 0.003) [ 40 ].…”

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Proposed public policies to improve outcomes in vascular surgery: an experts’ forum

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